Adherence and Alexithymia in Adolescent Renal Transplant Recipients
Ruben Schiavelli1, Mercedes Gargano1, Daniel Merino1, Malena Dubini Marchio1, Esteban Alvarenga1, Guillermo Martinez1, Julieta Raño1, Veronica Gambina1, Gabriel Chanta1, Mauricio Pattin1.
1Nephrology and Renal Transplant Division , Argerich Hospital, Buenos Aires , Argentina
Introduction: Renal transplantation is the best therapeutic option for patients with chronic kidney disease. Non-adherence to immunosuppressive therapy results in renal graft rejection and loss. The adolescent population is the most vulnerable and least adherent to post-transplant therapy, which is why it is advisable to assess adherence in this age group.
Etymologically, ‘alexithymia’ means “absence of words for emotions[A1] ”, and it has been described in patients with psychosomatic disorders, showing limitations in their emotional functioning, impoverished inner fantasy lives, and inability to find appropriate words to describe their feelings.
This study aims at describing alexithymia and its relation to therapy non-adherence in a group of adolescent renal transplant patients (ARTPs).
Materials and Methods: ARTPs between 18 and 24 years of age, currently followed up by an adult transplant team, but transplanted at a pediatric institution, were assessed. The validated Simplified Medication Adherence Questionnaire (SMAQ) and the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20) were administered to a group of adolescents.
Results: Twenty-eight ARTPs currently followed up at our service were surveyed. Their average age was 20.35 (18-24), and gender distribution was 16 (57.14%) women and 12 (42.86%) men.
The prevalence of non-adherence in all the patients studied was 75% (21/28).
Acute rejections were found in 35.7% (10/28) of all the ARTPs. In the group of non-adherent ARTPs, rejection accounted for 47.61% (10/21), while there was no rejection in the adherent group (0/7). p=0.02
Alexithymia was found in 82.14% of all the ARTPs (23/28). The presence of alexithymia accounted for 71.42% (5/7) in the group of adherent ARTPs and 85.71% (18/21) in the group of non-adherent ARTPs. p=NS
Conclusions: Non-adherence in ARTPs is high and increases the risk of rejection. The presence of alexithymia in this risk group may be related to non-adherence to immunosuppressive therapy. The number of patients should be increased to confirm these data.
